Journal of the Korean Association of Oral and Maxillofacial Surgeons

The Korean Association of Oral and Maxillofacial Surgeons (대한구강악안면외과학회)
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Comparative study on the estimated blood loss follwing to orthognathic surgeries

다양한 악교정 술식 조합에 따른 실혈양의 비교 연구

  • Jang, Jin-Hyun (Department of Oral and Maxillofacial Surgery, School of Medicine, Ewha Womans University) ;
  • Kim, Jin-Woo (Department of Oral and Maxillofacial Surgery, School of Medicine, Ewha Womans University) ;
  • Park, Sung-Ho (Department of Oral and Maxillofacial Surgery, School of Medicine, Ewha Womans University) ;
  • Kim, Myung-Rae (Department of Oral and Maxillofacial Surgery, School of Medicine, Ewha Womans University) ;
  • Kim, Sun-Jong (Department of Oral and Maxillofacial Surgery, School of Medicine, Ewha Womans University)
  • 장진현 (이화여자대학교 의학전문대학원 치과학교실 구강악안면외과) ;
  • 김진우 (이화여자대학교 의학전문대학원 치과학교실 구강악안면외과) ;
  • 박성호 (이화여자대학교 의학전문대학원 치과학교실 구강악안면외과) ;
  • 김명래 (이화여자대학교 의학전문대학원 치과학교실 구강악안면외과) ;
  • 김선종 (이화여자대학교 의학전문대학원 치과학교실 구강악안면외과)
  • Received : 2011.03.27
  • Accepted : 2011.07.26
  • Published : 2011.08.31
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Abstract

Purpose: The aim of this study was to compare the estimated blood loss and determine the change in hemoglobin depending on the combination of each orthognathic surgery. Subjects and Methods: The subjects of this study were patients who underwent orthognathic surgery among those diagnosed with a dentofaical deformity in Mok-Dong hospital, Ewha Womans University from 2002 to 2009. One hundred patients (men - 36, women - 64, mean age of $24.5{\pm}4.6$) participated in the study and were divided into four groups (group 1 - bilateral sagittal ramus osteotomy [BSSRO], group 2 - BSSRO+Genioplasty, group 3 - Lefort 1+BSSRO+genioplasty, group 4 - anterior segmental osteotomy on maxilla and mandible). A comparative study on the estimated blood loss (EBL), operation time, peri-operative changes in hemoglobin was performed using anesthesia records. The results were analyzed statistically using a Mann-Whitney U-test and Spearman's Rho test - SPSS 12.0 (SPSS Inc. Chicago, IL, USA). Results: In group 1 (BSSRO), the mean EBL, operation time and change in hemoglobin was $394.43{\pm}52.69$ ml, $184{\pm}42.33$ minutes, and 1.43, respectively, In group 2 (BSSRO+genioplasty), it was $556.32{\pm}63.42$ ml, $231{\pm}37.45$ minutes, and 1.80, respectively. In group 3 (Lefort 1+BSSRO+Genioplasty), it was $820.55{\pm}105.54$ ml, $320{\pm}15.41$ minutes, and 2.73, respectively. In group 4 (segmental osteotomy), it was $1025.39{\pm}160.21$ ml, $355{\pm}20.10$ minutes, and 3.33, respectively. In particular, in group 3, significant differences were observed depending on the method of the orthognathic surgery. The mean EBL in a Lefort 1 osteotomy with advancement was only 687 ml, whereas Lefort 1 osteotomy with canting correction (992 ml), even impaction (764 ml), and posterior nasal spine impaction (100 ml) showed a much higher EBL. Conclusion: From these results, the EBL and peri-operation hemoglobin increased as treatment plans became more complicated and increasing operation time. Safe orthognathic surgery should be performed by applying proper autologous transfusion plans based on the average EBL of each orthognathic surgery type.

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References

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